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“Kim Oswalt, an American psychotherapist who has been working with transgender clients in Japan for nearly five years, does not view transsexuality as a mental disorder. The very real suffering that Oswalt seeks to relieve is, she says, partly rooted in the client’s social context — in society’s rigid insistence on stable, binary gender role archetypes. Seen in this light, the true disorder becomes the widespread aversion known as transphobia: intolerant attitudes and discriminatory behavior towards transgender people. In many cases, Oswalt says, transgender clients themselves internalize this transphobia, setting up a severe inner conflict.”